Provider Demographics
NPI:1275521130
Name:PINTO, DUANE SIDNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:SIDNEY
Last Name:PINTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 DEACONESS RD
Mailing Address - Street 2:PALMER 415
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5321
Mailing Address - Country:US
Mailing Address - Phone:617-632-7483
Mailing Address - Fax:617-632-7460
Practice Address - Street 1:1 DEACONESS RD
Practice Address - Street 2:PALMER 415
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5321
Practice Address - Country:US
Practice Address - Phone:617-632-7483
Practice Address - Fax:617-632-7460
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA157621207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA157621OtherSTATE LICENSE
MAMP0338562AOtherMA CONTROLLED SUBSTANCE
MP3201686Medicaid
MP3201686Medicaid
H18808Medicare UPIN
MP3201686Medicaid